1366646986 NPI number — HELEN STOSEL MD INC

Table of content: (NPI 1366646986)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366646986 NPI number — HELEN STOSEL MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HELEN STOSEL MD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366646986
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26047 ACERO
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
MISSION VIEJO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92691-7950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-951-7100
Provider Business Mailing Address Fax Number:
949-951-7110

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26047 ACERO
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
MISSION VIEJO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92691-7950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-951-7100
Provider Business Practice Location Address Fax Number:
949-951-7110
Provider Enumeration Date:
06/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STOSEL
Authorized Official First Name:
HELEN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
949-951-7100

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X , with the licence number:  G68931 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: W20990 . This is a "GROUP PTAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00G689310 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com